Long-term effects of obesity in children

The prevalence of childhood obesity is growing at an alarming rate, with 1.65 million Malaysian schoolchildren expected to be overweight or obese by 2025.

AT In this first article in a two-part series, we will look first at the detrimental health effects of childhood obesity, and in the second part, underweight and malnourished children.

The World Health Organization (WHO) reported that global obesity tripled between 1975 and 2016.

Here in Malaysia, we already have the unflattering title of the fattest nation in Southeast Asia. According to our Department of Health’s 2019 National Health and Disease Survey, approximately 50% of our adult population is overweight or obese, up from 45% in 2011.

This trend has not bypassed children: the national prevalence of obesity in 2019 was 5.6% among children under the age of five and 14.8% among those aged five to 17; a significant increase from 6.1% in 2011.

An overweight child is defined as being between the 85th and 95th percentile for age on the growth chart, and obese refers to a child above the 95th percentile for age. Although genetics play some role in the development of childhood obesity, it accounts for less than 5% of the total cases. Uncontrolled eating and a sedentary, sedentary lifestyle remain major contributors to childhood obesity.

Most obese children become obese adults and develop many of the negative effects of obesity on their physical and psychological health.

The consequences of childhood obesity are that chronic diseases that we usually associate with the elderly are now observed even in childhood.

Conditions associated with childhood obesity include:


The number of children under the age of 12 who are diagnosed with type 2 diabetes is gradually increasing.

The risk of developing diabetes is quadrupled among obese children. Diabetes mellitus (high blood sugar) is a long-term disease that leads to serious complications in many organs of the body. Some of the complications include heart attack, stroke, visual impairment (retinopathy), kidney damage (nephropathy), nerve damage (neuropathy), and delayed wound healing.

Some of the symptoms of diabetes include excessive thirst (polydipsia), excessive amount and frequency of urination (polyuria), excessive hunger (polyphagia), and excessive nighttime urination (nocturia). You can often see dark spots around the neck and in the area of ​​skin folds (acanthosis nigricans), which is a sign of insulin resistance.


High blood pressure, the “silent killer”, has no signs or symptoms. Over time, this leads to the same multi-organ complications as diabetes. It is usually detected incidentally, for example, during hospitalization for other diseases or only when complications of hypertension occur.

high cholesterol

The constellation of high blood pressure, insulin resistance, and high cholesterol makes up what is known as the metabolic syndrome. Elevated cholesterol levels are common in childhood obesity. If left unchecked, it will further exacerbate the likelihood of developing cardiovascular disease.

fatty liver

A large amount of fat in the liver is called fatty liver disease. Eventually, fatty liver disease progresses to inflammation of the liver, damage to liver cells, and finally to irreversible liver failure.


Cholesterol is a component of bile, and a high concentration of cholesterol predisposes to the formation of gallstones.

sleep apnea

Obesity is a critical risk factor for obstructive sleep apnea. A person with sleep apnea often snores loudly in their sleep. They have sudden and repeated periods of not breathing during sleep, followed by a characteristic swallowing of air. This impairs the quality of their sleep and leads to excessive daytime sleepiness and poor concentration. The child’s performance in school will noticeably deteriorate due to the deterioration of memory and cognitive skills. They are also constantly irritable and may have difficulty communicating with other people.

Poor control of asthma

Achieving good asthma control becomes more challenging in obese children. Poorly controlled asthma has a significant impact on quality of life. Uncontrolled asthma predisposes a child to developing frequent and possibly severe asthma attacks, requiring hospitalization and even treatment in an intensive care unit.

Increased intracerebral pressure

A condition called idiopathic intracranial hypertension occurs when there is increased pressure in the brain. Half of the children who develop this condition are obese. The child complains of constant increasing headaches, sometimes accompanied by visual impairment.

Psychosocial Impact

Obese children are more likely to experience ridicule and bullying, which in turn affects their self-esteem and self-confidence. They are at an increased risk of developing depression and anxiety. Some react with emotional overeating, exacerbating the obesity-depression cycle.

Muscular and bone complications

Often, obese children complain of muscle pain and pain due to the strain on muscles, joints, and bones due to being overweight. Many develop bone deformities, such as bowed leg bones and dislocated hips.

Because of the many harmful effects caused by childhood obesity, it is becoming increasingly important for us to actively participate in its prevention, as a healthy lifestyle starts at home.

Teaching our children the importance of making healthy food choices and being physically active goes a long way in building a healthier society.

Dr. Yip pediatrician attached to KPJ Sentosa KL. Through his articles, he aims to help raise public awareness of common health issues in children.